Objective:To investigate the diagnostic efficacy of miR-9 and miR-195-3p for primary hepatic carcinoma (PHC), and the changes in miR-9 and miR-195-3p levels after interventional therapy.Methods:A total of 123 cases of PHC patients and 30 cases of liver cirrhosis patients attending Tangshan People's Hospital from May 2019 to May 2020 were selected as the PHC group and the liver cirrhosis group, respectively, and 50 people who were physically healthy during the same period were selected as the healthy group. Serum miR-9 and miR-195-3p levels were detected by real-time quantitative PCR. The relationship between serum miR-9 and miR-195-3p levels and clinical-pathological characteristics of PHC patients was analyzed. Receiver operator characteristic (ROC) curve was applied to analyze the diagnostic efficacy of miR-9 and miR-195-3p for PHC. The changes in serum miR-9 and miR-195-3p levels in PHC patients before and after transcatheter arterial chemoembolization (TACE) were compared.Results:There were statistically significant differences in serum miR-9 (0.99±0.10, 1.31±0.28, 1.68±0.43) and miR-195-3p (0.97±0.10, 0.83±0.22, 0.63±0.18) levels among the healthy group, liver cirrhosis group, and PHC group ( F=69.78, P<0.001; F=74.82, P<0.001), with serum miR-9 levels increased successively and miR-195-3p levels decreased successively among the three groups (all P<0.05). There were statistically significant differences in serum miR-9 ( t=7.45, P<0.001; t=5.32, P<0.001; t=4.96, P<0.001) and miR-195-3p ( t=16.17, P<0.001; t=4.21, P<0.001; t=7.53, P<0.001) levels in PHC patients with different maximum diameters of tumor, clinical stages and degrees of differentiation. ROC curve analysis showed that the area under the curve (AUC) for the combined differential diagnosis of liver cirrhosis and PHC by serum miR-9 and miR-195-3p testing was 0.919, which was higher than the AUC for the differential diagnosis of serum miR-9 (AUC: 0.712, Z=4.38, P<0.001) and miR-195-3p (AUC: 0.844, Z=2.04, P=0.042) alone. After TACE treatment, serum miR-9 levels decreased (1.39±0.21 vs. 1.68±0.43, t=14.22, P<0.001) and miR-195-3p levels increased (0.78±0.22 vs. 0.63±0.18, t=14.84, P<0.001) in patients compared to pre-treatment levels. Conclusion:Serum miR-9 level is increased and miR-195-3p level is decreased in patients with PHC compared with patients with liver cirrhosis and healthy subjects, and the combination of the two has high differential diagnostic efficacy for liver cirrhosis and PHC. After TACE treatment, serum miR-9 level is decreased and miR-195-3p level is increased in PHC patients.

Objective To investigate the relationship between serum microRNAs(miRNAs,miR)-216b and miR-132 expressions and clinical prognosis in patients with gastric cancer.Methods From January 2018 to February 2020,87 gastric cancer patients who visited Jiamusi Central Hospital were selected as the gastric cancer group,while 87 healthy individuals who underwent physical examinations in the hospital were collected as the control group.Quantitative real-time PCR(qRT-PCR)was applied to detect the expression levels of miR-216b and miR-132 in serum.The relationship between the expression levels ofmiR-216b and miR-132 in the serum of gastric cancer patients and their clinical pathological characteristics was analyzed.According to the survival or death status of gastric cancer patients during the follow-up period,these patients were divided into a good prognosis group(survival,n=51)and a poor prognosis group(death,n=36).The predictive value of serum miR-216b and miR-132 expression levels on the prognosis of gastric cancer patients was analyzed using the receiver operating characteristic(ROC)curve.COX regression was applied to analyze factors affecting the prognosis of gastric cancer patients.Results Compared with the control group,the expression levels of miR-216b(0.69±0.20vs1.02±0.24)and miR-132(0.73±0.19 vs 1.01±0.22)in serum of gastric cancer group were decreased,and the differences were significant(t=9.853,8.984,all P＜0.001).The expression levels of miR-216b and miR-132 in serum of gastric cancer patients with low differentiation,TNM stages Ⅲ±Ⅳ,lymph node metastasis,and distant metastasis were significantly lower than those of gastric cancer patients with medium and high differentiation,TNM stages Ⅰ±Ⅱ,no lymph node metastasis and no distant metastasis,and the differences were statistically significant(t=6.266,3.412,2.890,2.723;4.999,3.734,4.180,5.502,all P＜0.05).Compared with the good prognosis group,the expression levels of miR-216b(0.56±0.16 vs 0.78±0.23)and miR-132(0.60±0.11 vs 0.82±0.25)in serum of gastric cancer patients in the poor prognosis group were decreased,and the differences were statistically significant(t=4.952,4.946,all P＜0.001).The areas under the cure(AUC)of serum miR-216b,miR-132 and their combination predicted the prognosis of gastric cancer patients was 0.797(95％CI:0.706～0.889),0.832(95％CI:0.745～0.918)and 0.900(95％CI:0.836～0.964),respectively.The sensitivity and specificity were 83.3％,68.6％;97.2％,62.7％and 79.4％,72.5％,respectively.When the cut-off values of serum miR-216b and miR-132 for predicting poor prognosis of gastric cancer patients were 0.66 and 0.76,respectively,the sensitivity of the prediction were relatively high.COX regression analysis showed that low expression of miR-216b and miR-132,poorly differentiated degree,TNM stage Ⅲ+Ⅳ,lymph node metastasis,and distant metastasis were risk factors for poor prognosis in gastric cancer patients(all P＜0.05).Conclusion MiR-216b and miR-132 were low expressed in the serum of gastric cancer patients,and they could serve as effective biomarkers for predicting the prognosis of gastric cancer patients.

Objective To develop an nomogram model for predicting the lung hemorrhage after CT-guided microwave ablation(MWA)in stage ⅠA non-small cell lung cancer(NSCLC)patients.Methods Stage ⅠA NSCLC patients treated with MWA were randomly divided into a training group and a validation group in a 3∶1 ratio.The risk factors of lung hemorrhage identified by univariable and multivariable logistic regression analysis in the training group were used to develop a nomogram model.The C-statistic was used to evaluate the predictive accuracy in both the training and validation groups.Results A total of 208 patients(training group,156 cases;validation group,52 cases)were included in this study.The risk factors of lung hemorrhage after MWA were the number of vessels passing through the lung parenchyma[odds ratio(OR)=3.815;95％confidence interval(CI)1.485-9.800;P=0.005],number of focal blood supplies(OR=2.922;95％CI 1.198-7.126;P=0.018)and number of punctures(OR=2.802;95％CI 1.792-4.381;P＜0.001).The C-statistic in training group was 0.928(95％CI 0.875-0.963)and the C-statistic in validation group was 0.906(95％CI 0.793-0.969).The optimal cut-off value for lung hemorrhage was 0.14.Conclusion The nomogram model can effectively predict the lung hemorrhage after MWA.Patients showing a high risk(＞0.14)on the nomogram model should be monitored for lung hemorrhage.

Objective To enhance CT radiation dose management in radiology department via applying Six Sigma management method.Methods The radiation quality control processes in the radiology department were optimized according to the Six Sigma quality management DMAIC pattern.The volume CT dose index(CTDIvol),dose length product(DLP),radiation quality control problems of adult and pediatric CT scans from January 2022 to February 2022 were collected as baseline data,and data collected from August 2022 to September 2022 were taken as the control group for analysis via Six Sigma management method.All data of the dose values and problem rates were compared and analyzed between before and after Six Sigma management methods.Results The DLP in the adult group was decreased by 65.5％in computed tomography urography(CTU),decreased by 25.5％in neck enhancement,decreased by 9.8％in head,decreased by 24％in facial cranial,and decreased by 27.7％in chest enhancement,with a statistical difference(P＜0.05).While DLP in the adult group was decreased by 9.7％in abdominal enhancement,with no significant difference(P＞0.05).The DLP in the pediatric(＜1 year)group was increased by 35％in head scans,with no significant difference(P＞0.05).While the DLP was decreased by 30.2％in 1 to 5 years group,decreased by 21.8％in 6 to 10 years group,decreased by 27.6％in 11 to 15 years group,with statistical difference(P＜0.05).The DLP of facial cranial was decreased by 43.3％in 6 to 10 years group,decreased by 29.1％in 11 to 15 years group,with statistical difference(P＜0.05).The DLP of chest was decreased by 13％in＜1 year group(P＞0.05),increased by 2.2％in 1 to 5 years group(P＞0.05),decreased by 42.6％in 6 to 10 years group,decreased by 54.2％in 11 to 15 years group(P＜0.05).The incidence of radiological quality control problems of after Six Sigma management was significantly lower than that of before Six Sigma management(P＜0.05).Conclusion Six Sigma management method can identify problems in the clinical practice and enhance the ability of radiation quality control through optimization.

Objective:In order to determine the development potential of human embryos in vitro, amino acid and carnitine levels were measured in the culture medium of different grades of early human embryos. Methods:From the infertile couples who received in vitro fertilization-embryo transfer treatment in the Department of Reproductive Medicine of Linyi People′s Hospital from June 2022 to December 2022, the age of the women was defined as 25-35 years old [31.5(26.5, 33.25)] with 8-20 eggs, 126 cultured cells and embryos of the third day were randomly collected from infertile couples. They were divided into three groups according to the morphological level of the corresponding embryos: excellent, neutral and poor. Amino acids and L-carnitines levels in culture medium were detected by liquid chromatography-mass spectrometry (LC-MS). Using analysis of variance to compare differences among groups, correlation analysis, factor analysis was performed to analyze the association between the levels of amino acids and L-carnitines and development potential of early human embryos.Results:The value of Methionine/Phenylalanine was found statistically different among superior embryo (3.09±1.67), moderate embryo (4.00±1.19) and inferior embryo (4.99±2.04). The difference between the three groups was statistically different ( F=7.09, P<0.05): superior embryo vs moderate embryo ( t=-0.91, P<0.05), superior embryo vs inferior embryo ( t=-1.91, P<0.05), moderate embryo vs inferior embryo ( t=-0.99, P<0.05). Among different amino acids, Phe had the strongest positive correlation with Tyr ( r=0.99, P<0.01). Among different carnitines, C 8/C 10 has the strongest positive correlation with C 5DC+C 6OH/C 16( r=0.44, P<0.01). The weight value of leucine (isoleucine), arginine, valine/phenylalanine, glycine, tyrosine and carnitine(C 5DC+C 6OH)/C 8 calculated by the least square fitting model is 2.22, 1.99, 1.65, 1.54, 1.21 and 1.15 respectively. Conclusion:Leucine, arginine, valine/phenylalanine, glycine, tyrosine and carnitine (C 5DC+C 6OH)/C 8 in embryo culture medium were significantly correlated with the levels of early human embryos in vitro.

Objective:To investigate the pathogenic gene of the two pedigrees with hereditary synpolydactyly.Methods:Clinical data of two families admitted to the Linyi People’s Hospital due to hereditary synpolydactyly in January 2019 and December 2020 were recruited. Peripheral blood samples were collected and genomic DNAs were extracted. Whole exome sequencing was conducted to detect the pathological mutations and Sanger sequencing was used to verify the variants. The pathogenicity of the mutations was predicted according to PolyPhen-2, PROVEAN and the American College of Medical Genetics and Genomics (ACMG) guidelines.Results:There were a total of 5 patients (2 males and 3 females) in family 1. The proband was an 8-year-old girl, showed syndactyly of the third and fourth fingers of the right hand with webbed fusion and distal fingernail fusion. The rest of the fingers and feet were normal. There were a total of 4 patients (all females) in family 2. The proband was a 4-year-old girl, and showed the interlocking of the third and fourth fingers on both hands and the lateral curvature of the indicator finger. Two mutations of the homeobox D13(HOXD13) gene, c. 917G>A and c. 917G>T were detected and co-segregated with the disease phenotype in two affected families. Moreover, the variant of c. 917G>T is a novel missense mutation of the HOXD13 gene. According to ACMG guidelines, c. 917G>A meets the criteria of pathogenic variation (PS1+ PS4+ PM1+ PM2+ PP3) and c. 917G>T meets the criteria of likely pathogenic variation (PM2+ PM5+ PP3+ PP4).Conclusion:The HOXD13 gene c. 917G>A and c. 917G>T mutations are identified to be responsible for hereditary synpolydactyly in these two families.

Objective:To investigate the pathogenic gene of the two pedigrees with hereditary synpolydactyly.Methods:Clinical data of two families admitted to the Linyi People’s Hospital due to hereditary synpolydactyly in January 2019 and December 2020 were recruited. Peripheral blood samples were collected and genomic DNAs were extracted. Whole exome sequencing was conducted to detect the pathological mutations and Sanger sequencing was used to verify the variants. The pathogenicity of the mutations was predicted according to PolyPhen-2, PROVEAN and the American College of Medical Genetics and Genomics (ACMG) guidelines.Results:There were a total of 5 patients (2 males and 3 females) in family 1. The proband was an 8-year-old girl, showed syndactyly of the third and fourth fingers of the right hand with webbed fusion and distal fingernail fusion. The rest of the fingers and feet were normal. There were a total of 4 patients (all females) in family 2. The proband was a 4-year-old girl, and showed the interlocking of the third and fourth fingers on both hands and the lateral curvature of the indicator finger. Two mutations of the homeobox D13(HOXD13) gene, c. 917G>A and c. 917G>T were detected and co-segregated with the disease phenotype in two affected families. Moreover, the variant of c. 917G>T is a novel missense mutation of the HOXD13 gene. According to ACMG guidelines, c. 917G>A meets the criteria of pathogenic variation (PS1+ PS4+ PM1+ PM2+ PP3) and c. 917G>T meets the criteria of likely pathogenic variation (PM2+ PM5+ PP3+ PP4).Conclusion:The HOXD13 gene c. 917G>A and c. 917G>T mutations are identified to be responsible for hereditary synpolydactyly in these two families.

Obsjective To analyze the inflammation characteristics and changes of small airway function in patients with eosinophil and neutrophil asthma, and provide evidence for individualized treatment of asthma. Methods:Using a cross-sectional study, 46 patients with eosinophilic asthma and 42 patients with neutrophilic asthma confirmed by cytology of induced sputum were recruited from July 1, 2017 to June 30, 2019 at the respiratory Department of Respiratory Medicine,Jinshan Branch of the Sixth People's Hospital of Shanghai. Patients were divided by asthma category into eosinophilic asthma group and neutrophilic asthma group.The severity of acute attack, the score of asthma control test (ACT) and the concentration of serum C-reactive protein (CRP) were compared between the two groups The fraction of exhaled nitric oxide (FeNO), related cytokines(interleukin-4(IL-4), interleukin-5(IL-5), interleukin-13(IL-13), interleukin-17(IL-17) and interferon γ(IFN-γ)) in peripheral blood and induced sputum supernatant and lung function indicators (forced exhalation volume in one second (FEV1)% percent predicted (%pred), maximal mid-expiratory flow (MMEF)% pred, forced expiratory flow (FEF) 75% pred, forced expiratory flow at 50% of FVC exhaled (FEF50%) pred were detected. Independent sample t-test was used for the comparison between measurement data groups comforming to normal distritution, rank sum test was used for the comparison between measurement data groups not conforming to normal distribution, and χ 2 test was used for the comparison of counting data. Results:There were no significant differences in the general data and ACT scores between the two groups (all P>0.05). The ratio of severe and critical degree (52.38%(22/42)), uncontrolled and partially controlled patients (59.52%(25/42)), CRP level (24.6(7.1, 35.0) mg/L) in neutrophil asthma group were higher than those in eosinophilic asthma group(30.43% (14/46), 36.96% (17/46), and 8.5 (2.0, 12.0) mg/L, respectively) (χ 2=4.37, χ 2=4.48, Z=4.76; P=0.036, P=0.034, P<0.001). The concentration of FeNO was higher in eosinophilic asthma group (76(54,93) ppb) than that in neutrophil asthma group(27(15,41) ppb),and the differences was statistically significant ( Z=6.52, P<0.001). The values of FEV1% pred ((56.13±21.51)%), MMEF% pred ((62.03±23.97)%), FEF75% pred ((54.42±20.49)%), FEF50% pred ((66.89±26.47)%) in neutrophil asthma group were lower than those in eosinophilic asthma group ((68.53±29.81)%, (72.16±23.05)%, (65.38±25.46)% and (79.86±27.61)%), and the difference between the two groups was statistically significant( t values were 2.25, 2.02, 2.21, 2.24; P values were 0.027, 0.046, 0.030, 0.027). The concentrations of serum IL-4((49.42±24.46) ng/L), IL-5((104.89±43.91) ng/L) and IL-4((44.49±19.12) ng/L), IL-5((95.45±28.58) ng/L) in induced sputum supernatant were higher than neutrophilic asthma group((32.29±14.19), (50.35±22.30), (33.33±15.08), (55.61±26.41) ng/L). The difference between the two groups was statistically significant ( t values were 4.06, 7.44, 3.02, 6.77, P values were <0.001, <0.001, 0.003, <0.001). In eosinophilic asthma group, the concentrations of serum IL-13 ((76.18±20.62) ng/L), IL-17 ((31.32±9.32) ng/L), IFN-γ ((18.27±5.56) ng/L) and IL-13((71.08±20.08) ng/L), IL-17((26.29±6.70) ng/L), and IFN-γ((17.61±5.94) ng/L) in induced sputum supernatant were lower than those in neutrophilic asthma group((153.83±44.53 ) ng/L, (55.27±18.89) ng/L, (26.46±10.08) ng/L, (120.32±28.41) ng/L, (44.99±12.66) ng/L, (23.91±7.66) ng/L). The difference between the two groups was statistically significant ( t values were 10.33, 7.43, 4.66,9.31,8.54,4.33, respectively; all P<0.001). Conclusion:Eosinophilic asthma and neutrophil asthma have different inflammation, small airway function characteristics and different response to treatment. The small airway function changes in early stage of neutrophil asthma are more obvious.

DNA is a biological polymer that encodes and stores genetic information in all living organism. Particularly, the precise nucleobase pairing inside DNA is exploited for the self-assembling of nanostructures with defined size, shape and functionality. These DNA nanostructures are known as framework nucleic acids (FNAs) for their skeleton-like features. Recently, FNAs have been explored in various fields ranging from physics, chemistry to biology. In this review, we mainly focus on the recent progress of FNAs in a pharmaceutical perspective. We summarize the advantages and applications of FNAs for drug discovery, drug delivery and drug analysis. We further discuss the drawbacks of FNAs and provide an outlook on the pharmaceutical research direction of FNAs in the future.

This project starts with the teaching of clinical anatomy for eight-year medical students, selects specialists to enter the courses according to the content of clinical anatomy, and explores the deep integration of basic and clinical education. This study used the self-made questionnaire to evaluate the effect of the integrated teaching model, and Likert scale was used to score. Meanwhile, the correlation between the scores of each question and total points was analyzed with the item analysis. Moreover, we assessed the principal components through the exploratory factor analysis. The results showed that more than 95% questioned students thought the preclinical education integrated with clinical medicine teaching model is necessary and practical, which can assist medical students in the anatomical structure learning combined with clinical disease, and meanwhile cultivate students' clinical thinking. Only fewer than 10% thought it can connect the basic knowledge and clinical cases effectively, and over 35% thought there are difficulties. Additionally, more than half students (54%) hold the negative attitude which clinicians can't completely replace basic teachers in teaching. Our finding suggests that the integrated teaching model is attractive and feasible. Nonetheless, clinicians can’t replace preclinical teachers completely in the clinical anatomy education yet.